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Heart failure most often begins with diastolic dysfunction, marked by increased rigidity of the myocardium and slower ventricular relaxation. Myocardial rigidity is the result of changes to the extracellular matrix of the myocardium, with increased collagen, increased fibronectin, and reduced elastin—mediated by activity of matrix metalloproteinases (MMPs). Vitamin D has been shown to stimulate tissue inhibitors of MMPs as well as suppress inflammatory pathways, preventing excessive degradation of the extracellular matrix.

Short sleep duration and poor diet have independently been associated with obesity, but little is known about the interaction between these 2 variables. A study published by Doo and Kim in Nutrients (2017) examined how the effect of sleep duration on obesity might be modified by consumption of dietary antioxidants.

Early menopause is defined as the natural cessation of menses before the age of 45 years. It is estimated to affect approximately 10% of women and is associated with a greater risk for osteoporosis, cardiovascular disease, and cognitive decline. Early menopause likely results from a combination of genetic and lifestyle factors, including diet. It is plausible that calcium and vitamin D may influence the risk of early menopause, as these nutrients have been implicated in other reproductive conditions, including polycystic ovarian syndrome, endometriosis, and premenstrual syndrome.

Sulforaphane is an organosulfur compound that naturally occurs in broccoli sprouts and other cruciferous vegetables. A research article, published in Science Translational Medicine in 2017, summarizes the work of Axelsson and colleagues on the effects of sulforaphane in type 2 diabetes. Their research includes genomic analyses, in vitro studies, animal models, and a human clinical trial.

Sarcopenia is defined as an age-related decline in muscle mass and muscle strength. One proposed mechanism of sarcopenia pathophysiology is a decrease in autophagy—a process that degrades and recycles cellular components to maintain cellular health. Studies have shown that autophagy is deficient in aging muscle cells and that deficient autophagy may lead to mitochondrial dysfunction and oxidative damage.

Standardized Ginkgo biloba extract contains polyphenols, flavonoids, terpene lactones, and other compounds that offer potential benefits for cognitive and physical performance. In a 2017 study published in Nutrients, researchers evaluated the effects of Ginkgo biloba supplementation on aerobic performance, blood antioxidant capacity, and expression of brain-derived neurotrophic factor (BDNF) in physically active, college-aged men.

Magnesium is an essential cofactor for hundreds of biochemical pathways, including production of hormones and neurotransmitters involved in mood regulation. Magnesium deficiency has been associated with depression, but clinical trials on magnesium as an intervention for active depression are limited. The first clinical trial on magnesium for depression in the United States was conducted by researchers Tarleton et al and published in 2017.

Atrial fibrillation is characterized by an irregular and rapid heart rate, dramatically increasing the risk of blood clot formation and stroke. Evidence suggests that the pathophysiology of atrial fibrillation begins with an inflammatory cascade, leading to production of reactive oxygen species and proliferation of fibroblasts. This cascade leads to electrical and structural remodeling of the atrium and symptoms of atrial fibrillation. It is thought that the antioxidant properties of flavonoids in chocolate might interfere with this pathophysiologic cascade and reduce the risk of atrial fibrillation. 

Coffee contains a variety of compounds, including caffeine, polyphenols, and minerals, that might contribute to cognitive health. Previous meta-analyses, based on small numbers of heterogeneous studies, have reported coffee consumption to reduce the risk of cognitive disorders. Researchers Wu at al attempted to strengthen the evidence related to coffee consumption and cognitive decline with a meta-analysis specific to prospective cohort studies and including a dose-response analysis.

Patients undergoing cardiac surgery are at an increased risk of systemic inflammation resulting from ischemia-reperfusion and oxidative stress. When surgery is performed with cardiopulmonary bypass—a technique that temporarily functions for the heart and lungs during the procedure—inflammation is further promoted by blood contact with non-endothelial surfaces. Complications of cardiac surgery are related to the inflammatory cascade and can include atrial fibrillation or stroke. Omega-3 fatty acids have shown promise for decreasing the incidence of perioperative atrial fibrillation and may reduce the risk of other complications because of their anti-inflammatory effects.

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